A c-section (or Caesarean section) is commonly performed when a natural birth is considered to be too risky and the mother’s or baby’s health is deemed to be at risk.

Today, however, private South African hospitals are performing far more c-sections than vaginal births and a c-section is becoming an elective procedure rather than a necessity. Mothers may be under the impression that a c-section is an easy way out of labour, or they may feel that a scheduled operation is far more convenient than trying to work around an unplanned 2am hospital visit (after their water breaks).

The increase in c-sections is not only in South Africa, but in reality the procedure is being performed far more often in many other countries around the world such as in China, Latin America and the US, where c-sections are being performed as much as 46% more than in earlier years. Interestingly the World Health Organization (WHO) has indicated that no region in the world is justified in having a caesarean rate which exceeds more than 10 to 15%.

If a caesarean is not a necessity, is opting for the procedure a wise choice?

Why choose to undergo a major operation, if it is not necessary?

Natural birth is exactly that - totally natural. Many experts agree that when a c-section is elected, babies may suffer an adverse reaction to the anaesthetic that is administered before the operation takes place. Due to the fact the date for the c-section is set a few days into the 39th week, there is always a risk of an early delivery and this means that mothers will have to deal with the complications which occur because of the premature delivery. When a baby is born naturally, a mother will go into labour – a sign that the baby is ready. Since the caesarean is scheduled before labour takes place, an early delivery is a high and real risk!

Another risk of the c-section is the hazards that the unborn baby could suffer while the procedure is underway. When a c-section is performed, an incision is made in the uterus and the baby is extracted. With a natural birth, the infant engages into the birth canal and the process allows the infant to prepare itself for the outside world. Natural birth takes places in stages and each stage is preparation for the mother and the baby, while a caesarean allows no time for the preparation to take place.

There are of course, cases where a c-section is the safest method of delivery and these cases include:

Multiple births (especially premature deliveries)

A drawn-out labour (or prolonged labour) and the failure of the labour to progress

If the infant appears to be in distress

Cord prolapsed or increased blood pressure or heart rate.

Where the baby is breech

When an instrument delivery (using forceps, etc.) fails

A baby which is extremely large

If the mother is HIV-positive - the c-section will generally eliminate mother to child transmission

Natural birth

Mothers who give birth naturally recover a lot faster than those who have had a caesarean delivery. After natural birth, there is no physical wound that will need to heal – unless an episiotomy has been done. In addition, the hospital stay is generally increased for mothers who deliver by c-section and research which has been conducted into a natural birth vs. C-section has shown that mothers who have delivered their babies by this method, will take lot longer to interact (or bond) with their infants, than those who give birth naturally. While in labour, the woman is able to walk around freely, change positions; due to the fact that a c-section is an operation, a woman is in a theatre and plays no role in the delivery of her child.

In terms of the benefits for the infants, during natural birth, endorphins are secreted and these endorphins have been shown to play a role in helping the new born baby adjust to life outside the womb, and the endorphins are also used to make the journey through the birth canal, more comforting for the baby. Babies who are delivered by caesarean are not exposed to these endorphins!

Giving birth naturally is certainly painful and tiring, however once it is over, the pain of the contractions and the hard work of the labour and the delivery are quickly forgotten. In a few hours, a mother will be able to enjoy a warm shower, and will usually have a healthy appetite. Pain after a caesarean will prevent a woman from getting up on the first day and walking, and even breastfeeding will be uncomfortable and painful for many days after the delivery!

What’s more a c-section is considered to be a relatively high risk to the mother's health, as infections to the wound may occur, along with haemorrhaging, injury to internal organs, and complications while under anaesthetic. Psychological complications may also occur after the birth.

In addition to the health risks, a c-section is far more costly than natural birth, so not only is the procedure a lot more expensive, but a mother will be required to spend additional days in hospital to recuperate.

If a medical caregiver has advised that a caesarean section is necessary, the woman should exercise their right to choice and remember that they are urged to question the doctor’s decision. If a c-section is considered to be the safest delivery method – the expectant mom should conduct investigations to determine if this method is the only way forward!

Facts surrounding c-sections

Caesarean rates are also often influenced by non-medical factors. Rates for a c-section are higher for women who are covered by private medical aids, use private rather than public healthcare facilities, are older, are married, and who have a higher level of education and fall into a higher socio-economic bracket.

Several South African private hospitals have reported that caesarean section rates are as high as 98%, which means that South Africa has one of the highest C-section rates in the world

Do not allow a healthcare provider to bully you into having a c-section, simply because it is more convenient! Choose to examine the facts and make an educated choice.